Citation Nr: 21006671 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 16-62 298 DATE: February 4, 2021 ORDER Entitlement to disability ratings in excess of 10 percent for postoperative residuals of left hallux valgus and 10 percent for postoperative residuals for right hallux valgus has been withdrawn and is dismissed. Entitlement to a disability rating in excess of 10 percent for thoracolumbar strain prior to July 28, 2020, and in excess of 20 percent from July 28, 2020, is denied. Entitlement to a disability rating in excess of 10 percent for left hip bursitis is denied. FINDINGS OF FACT 1. At the December 2020 Board hearing, the Veteran requested to withdraw her appeals for entitlement to increased ratings for postoperative residuals of bilateral hallux valgus. 2. During the pendency of the appeal, the preponderance of the evidence shows that the Veteran's back disability is not manifested by ankylosis; forward flexion of the thoracolumbar spine 60 degrees or less; or incapacitating episodes of IVDS that required bed rest prescribed by a physician and treatment by a physician. 3. Prior to July 28, 2020, the preponderance of the evidence does not show muscle spasm or guarding severe enough to result in abnormal gait or abnormal spine contour. 4. During the pendency of the appeal, the preponderance of the evidence shows that the Veteran’s left hip disability was not manifested by ankylosis; flail hip joint; impairment of the femur; flexion limited to 45 degrees; limitation of rotation where the individual cannot toe-out more than 15 degrees on the affected leg; limitation of adduction where the individual cannot cross the legs; or limitation of abduction where there is motion lost beyond 10 degrees. CONCLUSIONS OF LAW 1. The criteria for withdrawal of bilateral hallux valgus appeals by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. From July 28, 2020, the criteria for an increased initial disability rating in excess of 20 percent for a back disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5237-5243. 3. Prior to July 28, 2020, the criteria for an increased initial disability rating in excess of 10 percent for a back disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5235-5243. 4. The criteria for a disability rating in excess of 10 percent for a left hip disability are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.14, 4.40, 4.45, 4.71a, DC 5250-5255. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from January 2011 to November 2013. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2020, the Veteran testified during a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. During the pendency of the appeal, a July 2020 rating decision granted increased rating and a separate rating for the Veteran’s back and left hip disabilities. As the increased ratings were not granted for the entire claims period or for the highest available disability ratings, these increases are considered partial grants. See AB v. Brown, 6 Vet. App. 35 (1993). As reflected on the title page of this decision, the Board has recharacterized the Veteran’s appeals to account for the partial grants. As a preliminary matter, the Board notes the Veteran’s pending increased rating claims for bilateral knee disabilities, bilateral ankle disabilities, and surgical scars were also briefly addressed during the December 2020 Board hearing. However, as these claims are currently still under development with the AOJ, they are not before the Board at this time. It was noted at the hearing that the issues cited above are the sole issues before the Board at this time. Withdrawal The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by the Veteran or by his or her authorized representative. 38 C.F.R. § 19.55. At the December 2020 Board hearing, the Veteran requested to withdraw her appeals for entitlement to increased ratings for postoperative residuals of bilateral hallux valgus. The Board notes that the Veteran is in receipt of the maximum schedular rating for hallux valgus under DC 5280 for each foot. 38 C.F.R. § 4.71a. The withdrawal request has been documented in the Veteran’s claims file. The Board concludes that the Veteran has withdrawn these appeals and, hence, there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeals for increased ratings for hallux valgus and they are dismissed. Increased Ratings Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by Diagnostic Codes. 38 C.F.R. § 4.27. When rating the Veteran’s service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as “staged” ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The assignment of a particular diagnostic code to evaluate a disability is "completely dependent on the facts of a particular case." See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the diagnosis, and demonstrated symptomatology. The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. Thus, with or without degenerative arthritis, it is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59; see Burton v. Shinseki, 25 Vet. App. 1, 5 (2011) (holding that the provisions of 38 C.F.R. § 4.59 are not limited to disabilities involving arthritis). Moreover, when evaluating musculoskeletal disabilities, VA may, in addition to applying the schedular criteria, assign a higher disability rating when the evidence demonstrates functional loss due to limited or excessive movement, pain, weakness, excessive fatigability, or incoordination, to include during flare-ups and with repeated use, if those factors are not considered in the rating criteria. See 38 C.F.R. § § 4.40, 4.45, 4.59; see also DeLuca v. Brown, 8 Vet. App. 202 (1995); Burton, 25 Vet. App. at 5. Nonetheless, a disability rating higher than the minimum compensable rating is not assignable under any diagnostic code relating to range of motion where pain does not cause a compensable functional loss. Rather, the "pain must affect some aspect of 'the normal working movements of the body' such as 'excursion, strength, speed, coordination, and endurance," as defined in 38 C.F.R. § 4.40, before a higher rating may be assigned. See Mitchell v. Shinseki, 25 Vet. App. 32, 37 (2011) (noting that while "pain may cause a functional loss, pain itself does not constitute a functional loss," and, is therefore, not grounds for entitlement to a higher disability rating). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). In evaluating the evidence in any given appeal, it is the responsibility of the Board to weigh the evidence and decide where to give credit and where to withhold the same and, in so doing, accept certain medical opinions over others. Schoolman v. West, 12 Vet. App. 307, 310-11 (1999). In this regard, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. See Owens v. Brown, 7 Vet. App. 429, 433 (1995). Entitlement to evaluation in excess of 10 percent for thoracolumbar strain (the back problem) prior to July 28, 2020, and in excess of 20 percent from to July 28, 2020. The Veteran contends that she is entitled to a disability rating higher than 10 percent for her service-connected back disability (thoracolumbar strain) prior to July 28, 2020, and higher than 20 percent from July 28, 2020. The regulations provide for evaluation of disabilities of the spine under the General Rating Formula for Diseases and Injuries of the Spine (General Rating Formula) or intervertebral disc syndrome (IVDS) may alternatively be rated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes (IVDS Formula), whichever method results in the higher evaluation when all disabilities are combined under 38 C.F.R. § 4.25. 38 C.F.R. § 4.71a, Note (6). Prior to July 28, 2020, the Veteran's service-connected back disability is rated as 10 percent disabling under DC 5237 (lumbosacral or cervical strain) effective November 30, 2013. From July 28, 2020, the Veteran’s back disability is rated as 20 percent disabling under DC 5237. The General Rating Formula for Diseases and Injuries of the Spine provides a 10 percent disability rating for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent disability rating is assigned for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 30 percent rating is warranted where there is forward flexion of the cervical spine 15 degrees or less; or favorable ankylosis of the entire cervical spine. A 40 percent rating is warranted where there is forward flexion of the thoracolumbar spine of 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A higher 50 percent evaluation is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is warranted if there is unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula. In addition, any associated objective neurologic abnormalities are evaluated separately under the appropriate diagnostic code. 38 C.F.R. § 4.71a, General Rating Formula, Note 1. For VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. 38 C.F.R. § 4.71a, General Rating Formula, Note 2; see also Plate V. Alternatively, intervertebral disc disease can be evaluated under the Formula for Rating IVDS Based on Incapacitating Episodes. Under that Formula, a 10 percent rating is assigned where intervertebral disc syndrome is manifested by incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months. A 20 percent rating is warranted where incapacitating episodes have a total duration of at least two weeks but less than 4 weeks during the past 12 months. A rating of 40 percent is warranted where there are incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. A maximum rating of 60 percent is warranted where the evidence reveals incapacitating episodes having a total duration of at least six weeks during the past 12 months. Incapacitating episodes are defined as requiring bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, IVDS Formula. The Veteran was provided VA examination for the spine in March 2013. The Veteran was diagnosed with recurrent mechanical thoracolumbar strain in quiescent. Examination revealed flexion to 90 degrees; extension to 30 degrees; left and right lateral rotation to 30 degrees; and right and left lateral flexion to 30 degrees. The examiner did not find objective evidence of pain following repetitive motion or additional limitation of range of motion after three repetitions. The examiner found no incapacitating episodes of spine disease. The examiner found normal posture, head position, symmetry in appearance, and gait. The examiner found no gibbus, kyphosis, lumbar lordosis, lumbar flattening, reverse lordosis, list, scoliosis, or ankylosis. The examiner found no spasm, atrophy, guarding, pain with motion, tenderness, or weakness. The examiner found normal reflex and sensory testing. The Veteran was provided another VA examination for back conditions in September 2016. The Veteran was diagnosed with lumbosacral strain. Examination revealed forward flexion to 90 degrees; extension to 30 degrees; right and left lateral rotation to 30 degrees; and right and left lateral flexion to 30 degrees. No pain was noted on ranges of motion, weightbearing, and palpation. The examiner did not find additional loss of function or range of motion after three repetitions. The examiner did not find pain, weakness, fatigability, or incoordination significantly limits functional ability with repeated use over a period of time. The examiner did not find pain, weakness, fatigability, or incoordination significantly limits functional ability with flare-ups. The examiner found that the Veteran does not have guarding or muscle spasm of the thoracolumbar spine. The examiner found normal muscle strength, no muscle atrophy, normal reflexes, and normal sensation to light touch. The examiner found no radiculopathy. There was no evidence of ankylosis of the spine or other neurological abnormalities. The examiner did not find that the Veteran has IVDS of the thoracolumbar spine. The examiner noted that imaging studies did not show arthritis. The examiner did not find any other pertinent physical findings, complications, conditions, signs or symptoms related to the Veteran’s back condition. The Veteran was provided yet another VA examination for back conditions in July 2020. The Veteran was diagnosed with lumbosacral strain and degenerative disc changes at L4-5 without nerve impingement. Examination revealed forward flexion to 80 degrees; extension to 30 degrees; right lateral rotation to 30 degrees; and left lateral rotation to 20 degrees; and right and left lateral flexion to 30 degrees. The examiner noted pain on examination that caused functional loss on forward flexion and left lateral rotation. The examiner found evidence of localized tenderness or pain on palpation. The examiner found evidence of pain with weight bearing. The examiner found that pain caused additional loss of function or range of motion after three repetitions, reducing extension to 25 degrees. The examiner found that pain significantly limits functional ability with repeated use over a period of time, resulting in forward flexion to 70 degrees, extension to 20 degrees, right lateral flexion to 20 degrees, left lateral flexion to 20 degree, right lateral rotation to 20 degrees, and left lateral rotation to 20 degrees. The Veteran did not report flare-ups. The examiner found no evidence of pain on passive range of motion testing of the back and no evidence of pain on non-weight bearing testing of the back. The examiner found that the Veteran does not have guarding. The examiner found normal muscle strength, no muscle atrophy, normal reflexes, and normal sensation to light touch. The examiner found no radiculopathy. There was no evidence of ankylosis of the spine or other neurological abnormalities. The examiner did not find that the Veteran has IVDS of the thoracolumbar spine. The examiner noted that the Veteran regularly uses a brace. The examiner found arthritis documented by imaging studies. The examiner did not find any other pertinent physical findings, complications, conditions, signs or symptoms related to the Veteran’s back condition. As discussed above, a rating of 20 percent requires physician-prescribed bed rest or incapacitating episodes as defined by VA regulation, lasting a total of at least two weeks but less than four weeks during a 12-month period. Ratings in excess of 20 percent require physician-prescribed bed rest or incapacitating episodes as defined by VA regulation, lasting a total four weeks or more during a 12-month period. The evidence does not show incapacitating episodes requiring bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, IVDS Formula. Accordingly, the Board finds that the Veteran is not entitled to higher disability ratings based upon incapacitating episodes at any time throughout the period on appeal. As the Veteran is not entitled to increased ratings based upon incapacitating episodes, it is necessary to determine whether she is entitled to higher ratings under the General Rating Formula. To warrant a 20 percent rating for a back disability under the General Rating Formula, there must be evidence of limitation of flexion to 60 degrees or less, or the combined range of motion of the thoracolumbar spine not greater than 120 degrees. 38 C.F.R. § 4.71a. A 40 percent rating is warranted for limitation of flexion to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine. A 50 percent evaluation is warranted if there is unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is warranted if there is unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula. During the entire pendency of the appeal, the record is negative for a diagnosis of ankylosis. All three VA examinations found that the Veteran did not have ankylosis and this medical opinion is not contradicted by any other medical evidence of record. The record is also negative for evidence of flexion to 60 degrees or less. The March 2013 and September 2016 VA examinations revealed forward flexion to 90 degrees and the July 2020 VA examination revealed forward flexion to 70 degrees with repeated use. All three examinations showed combined range of motion of the thoracolumbar spine greater than 120 degrees. During the entire pendency of the appeal, the preponderance of the evidence does not show that pain, weakness, fatigue, muscle spasms, or incoordination cause further functional loss that more nearly approximates forward flexion of the thoracolumbar spine 60 degrees or less or the combined range of motion of the thoracolumbar spine not greater than 120 degrees. See 38 C.F.R. § § 4.40, 4.45, 4.59; see also DeLuca v. Brown, 8 Vet. App. at 202 (1995); Burton, 25 Vet. App. at 5; Mitchell, 25 Vet. App. at 32. Prior to July 28, 2020, the record does not show muscle spasm or guarding severe enough to result in abnormal gait or abnormal spine contour. Therefore, the Board finds that the Veteran does not meet the criteria for a rating in excess of 10 percent for her back disability prior to July 28, 2020, or a rating in excess of 20 percent from July 28, 2020. The Board has also considered separate evaluations for neurological manifestations of the Veteran's service-connected lumbar disability. The evidence does not show that the Veteran has radiculopathy or any other neurological abnormalities associated with the service-connected back disability for which she is not already service connected. The Board acknowledges the Veteran's belief that her symptoms are of such severity as to warrant a higher rating for her back disability. In this case, the Veteran is competent to report symptoms because that requires only personal knowledge as it comes to her through her senses. Layno v. Brown, 6 Vet. App. 465 (1994). The Veteran is not, however, competent to identify a specific level of disability according to the appropriate diagnostic codes. Disability ratings are made by the application of a rating schedule which is based on average impairment of earning capacity as determined by the clinical evidence of record. Such competent evidence concerning the nature and extent of the Veteran's back condition has been provided by the medical personnel who have examined the Veteran during the current appeal and who have rendered pertinent opinions in conjunction with the examinations. The medical findings as provided in the examination reports directly address the criteria under which disability due to a back condition is rated. Even considering the Veteran's credible statements regarding the impact of her back condition and the credible statements of her friends and family, the findings of the examinations do not support the assignment of higher ratings or additional separate ratings. Therefore, the Board finds the examination reports to be more probative than the Veteran's subjective evidence of complaints regarding the severity of symptomatology because they provide objective medical evidence of the manifestations of the service-connected disabilities. Cartright v. Derwinski, 2 Vet. App. 24 (1991). Accordingly, the Board finds that the preponderance of the evidence is against the assignment of a rating higher than 10 percent prior to July 28, 2020, and a higher rating that 20 percent from July 28, 2020, for the Veteran's service-connected back disability and the claims must be denied. This finding does not suggest that the Veteran does not have back problems, simply the nature and extent of the problem is within the 10 percent and 20 percent evaluations based on the criteria, nothing more. A 10 percent and 20 percent back disability will cause the Veteran many problems, especially considering the nature of the Veteran’s career. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran's claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Neither the Veteran nor her representative has identified any other rating criteria that would provide a higher rating or an additional rating. However, the potential applications of various provisions of Title 38 of the Code of Federal Regulations (2016) have been considered as required by the holding of the Court in Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991). Entitlement to a disability rating in excess of 10 percent for left hip bursitis. The Veteran’s service-connected left hip disability is currently rated at 10 percent under DC 5253 for impairment of thigh, effective November 11, 2013, and 0 percent under DC 5252 for limitation of flexion of the thigh, effective January 29, 2020. 38 C.F.R. § 4.71a. DC 5250 through DC 5255 set forth the relevant provisions for disabilities of the hip and thigh. See 38 C.F.R. § 4.71a. Limitation of motion of the hip or thigh may be rated under DC 5250 (ankylosis of the hip), DC 5251 (limitation of extension), DC 5252 (limitation of flexion), or DC 5253 (impairment of the thigh). DC 5254 provides a rating for flail joint of the hip and DC 5255 provides ratings for impairment of the femur. DC 5250 provides for a 60 percent disability rating for favorable ankylosis of the hip which is in flexion at an angle between 20 degrees and 40 degrees and with slight adduction or abduction. A 70 percent disability rating is warranted for intermediate favorable ankylosis of the hip. A 90 percent disability rating is warranted for extremely unfavorable ankylosis of the hip where the foot does not reach the ground and crutches are necessitated. 38 C.F.R. § 4.71a. DC 5251 provides a 10 percent disability rating for limitation of extension of the thigh that is limited to 5 degrees. 38 C.F.R. § 4.71a. DC 5252 provides ratings based on limitation of flexion of the thigh. A 10 percent disability rating is for flexion of the thigh that is limited to 45 degrees; a 20 percent rating is for flexion of the thigh that is limited to 30 degrees; a 30 percent rating is for flexion of the thigh that is limited to 20 degrees; and a 40 percent rating is for flexion of the thigh that is limited to 10 degrees. 38 C.F.R. § 4.71a. Under DC 5253, impairment of the thigh may be rated based on limitation of abduction, limitation of adduction, or limitation of rotation. A 10 percent rating will be assigned for limitation of rotation where the individual cannot toe-out more than 15 degrees on the affected leg, or for limitation of adduction where the individual cannot cross the legs. A 20 percent rating will be assigned for limitation of abduction where there is motion lost beyond 10 degrees. 38 C.F.R. § 4.71a. Normal ranges of motion of the hip are hip flexion from 0 degrees to 125 degrees and hip abduction from 0 degrees to 45 degrees. 38 C.F.R. § 4.71, Plate II. DC 5254 provides an 80 percent rating for flail joint. 38 C.F.R. § 4.71a. Under DC 5255, malunion of the femur with moderate hip disability warrants a 20 percent rating, while malunion of the femur with marked hip disability warrants a 30 percent rating. A 60 percent rating is provided for fracture of the surgical neck of the femur with false joint or fracture of the shaft or anatomic neck of the femur with nonunion and without loose motion, and fracture of the shaft or anatomic neck of the femur with loose motion warrants 80 percent. 38 C.F.R. § 4.71a. The Veteran was provided a VA examination for a hip condition in March 2013. The Veteran was diagnosed with recurrent left hip bursitis in quiescent. The examiner found left flexion of 0 to 125 degrees, extension of 0 to 45 degrees, and abduction of 0 to 45 degrees. The examiner found that the Veteran can cross left leg over right and toe out greater than 15 degrees. The examiner found no evidence of pain with active motion. The examiner for no deformity, giving way, instability, pain, stiffness, weakness, incoordination, decreased speed of joint motion, or other symptoms during examination. The examiner noted no episodes of dislocation, subluxation, locking, effusion, or flareups. The Veteran was provided a VA examination for hip and thigh conditions in September 2016. The Veteran was diagnosed with left hip bursitis. The examiner found normal range of motion in the Veteran’s left hip and no pain was noted on examination. The examiner found no evidence of pain with weight bearing, localized tenderness, pain on palpation, or crepitus. The examiner found no additional loss of function or range of motion after three repetitions. The examiner found that pain, weakness, fatigability, or incoordination does not significantly limit functional ability with repeated use over time or flareups. The examiner found normal muscle strength, no muscle atrophy, and no ankylosis. The examiner found no malunion or nonunion of femur, flail joint hip, leg length discrepancy, or arthritis documented by imaging studies. The examiner found no other pertinent physical findings, complication, conditions, signs, or symptoms related to the Veteran’s hip condition. The Veteran was provided another VA examination for hip and thigh conditions in January 2020. The Veteran was diagnosed with left hip bursitis. The examiner found left flexion of 0 to 90 degrees, extension of 0 to 30 degrees, abduction of 0 to 30 degrees, adduction of 0 to 20 degrees, external rotation of 0 to 50 degrees, and internal rotation of 0 to 20 degrees. The examiner found that adduction is not limited such that the Veteran cannot cross legs. The examiner found pain on abduction, adduction, and external rotation, that does not result in or cause functional loss. The examiner found no evidence of localized tenderness, pain on palpation, pain on weight bearing, or crepitus. The examiner found not additional loss of function or range of motion with repetitive use. The examiner found that pain, fatigue, and weakness significantly limit functional ability with repeated use over time. The examiner described the functional loss as flexion of 0 to 75 degrees, extension of 0 to 30 degrees, abduction of 0 to 25 degrees, adduction of 0 to 20 degrees, external rotation of 0 to 40 degrees, and internal rotation of 0 to 20 degrees. The examiner found that pain, fatigue, incoordination, and weakness do not significantly limit functional ability with flareups. The examiner found that the Veteran’s left hip condition interferes with standing and sitting, causing pain with prolonged standing or sitting for more than 15 or 20 minutes. The examiner found normal muscle strength, no muscle atrophy, no ankylosis, and no arthritis confirmed by imaging studies. The examiner did not find malunion or nonunion of femur, flail hip joint, or leg length discrepancy. The examiner noted that Veteran’s labral tear repair with partial reduction of the right femoral head. The examiner found no other pertinent physical findings, complication, conditions, signs, or symptoms related to the Veteran’s hip condition. Based on the foregoing evidence, the Board finds that ratings in excess of the current 10 percent evaluation for the Veteran’s left hip disability are not warranted. See 38 C.F.R. § § 4.7, 4.71a. The evidence does not indicate that the Veteran has ankylosis, and thus, she is not eligible for a higher rating under DC 5250. Alternatively, higher or separate ratings are not available under the other diagnostic codes applicable to limitation of motion of the hip and thighs (DCs 5250, 5251, and 5253); as the preponderance of the evidence does not show that pain, weakness, fatigue, or incoordination cause further functional loss that more nearly approximates extension limited to 5 degrees, flexion limited to 45 degrees, limitation of rotation where the individual cannot toe-out more than 15 degrees on the affected leg, limitation of adduction where the individual cannot cross the legs, limitation of abduction where there is motion lost beyond 10 degrees. See 38 C.F.R. § § 4.40, 4.45, 4.59; see also DeLuca v. Brown, 8 Vet. App. at 202 (1995); Burton, 25 Vet. App. at 5; Mitchell, 25 Vet. App. at 32. The evidence does not indicate that the Veteran has flail hip joint or impairment of the femur, and thus, she is not eligible for a rating under DC 5254 or 5255. Again, while the Veteran believes a higher disability rating is warranted, the evidence of record, including VA examinations, does not support a disability rating in excess of 10 percent. While the Veteran is competent to report the symptoms of her disabilities, she is not competent to opine on matters requiring medical knowledge, such as determining the severity of her medical condition at any given time, based on the criteria above. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Nothing above suggests that the Veteran is not having problems with this disability. The only question is the degree of the problem based on the evidence and the law. It is important for the Veteran to understand that the medical findings provide highly probative evidence against the claim that the Board cannot, unfortunately, ignore. The medical findings outweigh the Veteran’s belief that her disability warrants a higher disability rating and provide a highly clear basis for the opinion. In this regard, it is also important for the Veteran to understand that a 10 percent disability evaluation will cause the Veteran problems impacting her day to day life. If it did not, there would no basis for the current evaluation. The Board has considered if the examinations for both problems are adequate. However, the Board finds that these examinations addressed what needed to be addressed in order to ascertain if the Veteran met the next higher evaluation, which is the purpose of the examinations in this case. The treatment records, which have also been reviewed, only support the findings of the examinations as a whole. More examinations, in light of a review of all the examinations that have been undertaken, and in light of a review of the treatment records, simply does not support a conclusion that a 7th or 8th examination in this case will provide a basis to grant this case. In summary, the Board finds that the preponderance of the evidence shows that the Veteran’s left hip disability was not manifested by ankylosis; flail hip joint; impairment of the femur; flexion limited to 45 degrees; limitation of rotation where the individual cannot toe-out more than 15 degrees on the affected leg; limitation of adduction where the individual cannot cross the legs; or limitation of abduction where there is motion lost beyond 10 degrees. Therefore, the Board finds that the criteria for a rating in excess of 10 percent are not met. See 38 C.F.R. § 4.71a; Fenderson, supra. In reaching these conclusions, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, where the preponderance of the evidence is against the Veteran’s claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Neither the Veteran nor her representative has identified any other rating criteria that would provide a higher rating or an additional rating. However, the potential applications of various provisions of Title 38 of the Code of Federal Regulations (2016) have been considered as required by the holding of the Court in Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991). John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. VanValkenburg, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.